Provider Demographics
NPI:1457336489
Name:COUNTY OF OURAY
Entity type:Organization
Organization Name:COUNTY OF OURAY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-325-7275
Mailing Address - Street 1:PO BOX 572
Mailing Address - Street 2:
Mailing Address - City:OURAY
Mailing Address - State:CO
Mailing Address - Zip Code:81427-0572
Mailing Address - Country:US
Mailing Address - Phone:970-252-9749
Mailing Address - Fax:970-249-8421
Practice Address - Street 1:541 4TH STREET
Practice Address - Street 2:
Practice Address - City:OURAY
Practice Address - State:CO
Practice Address - Zip Code:81427
Practice Address - Country:US
Practice Address - Phone:970-325-7275
Practice Address - Fax:970-325-0452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO98056103416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06611537Medicaid
COC61153OtherMEDICARE B